Little Evidence of Noncardiovascular Benefits from Statins

By Will Boggs MD

NEW YORK (Reuters Health) - There is little evidence that statins improve most noncardiovascular outcomes, according to an umbrella review of meta-analyses.

"What we found was that overall, the vast majority of associations and effects that we observed in the statin meta-analyses we reviewed suggested favorable effects for these drugs," Dr. Evropi Theodoratou from University of Edinburgh, UK told Reuters Health by email. "Yet, almost none of these positive effects seemed to have high credibility in our assessments."

Many recent meta-analyses have claimed that statins influence the outcomes of cancer, diabetes, and several other diseases.

Dr. Theodoratou's team explored 278 unique noncardiovascular outcomes from 112 meta-analyses of observational studies and 144 meta-analyses of randomized controlled trials (RCTs).

From the meta-analyses of observational studies, they ultimately found no convincing associations between statins and outcomes, but they identified two highly suggestive associations (reduced cancer mortality for patients with cancer who had prediagnosis statin intake and reduced exacerbations in patients with chronic obstructive pulmonary disease).

They also found 21 suggestive associations (including two adverse event associations of statin intake with myopathy and diabetes risk) and 42 weak associations, according to the October 9th Annals of Internal Medicine report.

From the meta-analyses of RCTs, the researchers identified only one outcome with sufficient evidence and no hints of bias (decreased all-cause mortality in patients with chronic kidney disease). There were no significant effects of statins on myopathy, myalgia, or rhabdomyolysis.

"The absence of harmful effects, especially those with highly convincing or highly suggestive evidence, is reassuring," Dr. Theodoratou said. "Yet, we cannot exclude the possibility that some of these harms - such as rhabdomyolysis or severe myopathy - may be too rare to rule out with certainty."

"The results of this umbrella review of existing meta-analyses do not support any change in the existing clinical recommendations regarding statin use for noncardiovascular conditions," she concluded.

SOURCE: https://bit.ly/2yl8skE

Ann Intern Med 2018.

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